Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial.
OBJECTIVE
The purpose of this study was to evaluate the quality of life (QOL) after laparoscopy-assisted distal gastrectomy (LADG) compared with open distal gastrectomy (ODG) in patients with early gastric cancer.


BACKGROUND
LADG has been beneficial in terms of pain, recovery, and morbidity when compared with open surgery with equal oncologic outcome. There has been no clinical study on QOL.


METHODS
From July 2003 to November 2005, 164 patients with newly diagnosed cT1N0M0 and cT1N1M0 distal gastric cancer were randomly assigned either to LADG or ODG. All patients were asked to complete the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 questionnaires preoperatively and postoperatively on regular follow-up visits.


RESULTS
Statistically significant differences were observed with a more favorable outcome noted in the LADG group with respect to intraoperative blood loss (P < 0.001), total amount of analgesics used (P = 0.019), the size of the wound (P < 0.0001), postoperative hospital stay (P < 0.0001), and QOL parameters of global health (P < 0.0001). Most of the scales on patient functioning including physical (P < 0.0005), role (P = 0.0011), emotional (P < 0.0001), social (P < 0.0001), and symptom scales such as fatigue (P < 0.0001), pain (P < 0.0001), appetite loss (P = 0.031), sleep disturbance (P = 0.003), dysphasia (P = 0.0024), gastro-esophageal reflux (P = 0.0127), dietary restriction (P = 0.0004), anxiety (P = 0.0036), dry mouth (P = 0.0007), and body image (P < 0.0001) were also significantly better in the LADG group compared with the ODG group.


CONCLUSIONS
Comparison of LADG to ODG in patients with early gastric cancer resulted in improved QOL outcomes in the patients followed for up to 3 months in the LADG group.
Kim
Young-Woo
YW
Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Republic of Korea. gskim@ncc.re.kr
Baik
Yong Hae
YH
Yun
Young Ho
YH
Nam
Byung Ho
BH
Kim
Dae Hyun
DH
Choi
Il Ju
IJ
Bae
Jae-Moon
JM
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome